The participants can deliver in the position they prefer, and if spontaneous delivery of the shoulders occurs, this is to be respected regardless of randomization. If during delivery the midwife judges that an alternative method of delivery is preferred with regard to the safety of the birthing mother, this overrules randomization. Episiotomy may be used in accordance to local guidelines as judged necessary by the midwife. In case of vacuum-assisted delivery, which according to guidelines is performed by physicians, the midwife delivers the shoulders. Any deviations from the protocol are registered on the clinical registration form.